Introduction
A common and persistent fungi-infection disease, with a certain percentage of patients in primary health-care facilities, is the haemophilus infections, or ash nails. Effective science-based treatment of the disease is important for improving the quality of life of patients and reducing the spread of the disease. Primary health-care institutions, because of their wide range of people they serve and the nature of their health-care resources, require a realistic treatment strategy.
II. BASIC KNOWLEDGE OF ELEMENTS IN THE FIELD
(i) Causes
Fingermap infections are caused mainly by skin fungi, yeast and non-skin fungi fungus. Of these, erythrocyte is the most common fungi. These fungi are easily bred in damp, warm environments such as public bathrooms, swimming pools, gymnasiums, where people are vulnerable to infection if their skin barriers are damaged. In addition, those who suffer from peptide and handplum can easily spread fungus to their fingernails if hygiene is not observed.
(ii) Clinical performance
Infection of fungi with nails results in changes in colours, such as yellowing, whitening, blacking, coarsening, thickening, condensed surfaces and, in some cases, separation of decks from the deck. These changes not only affect the aesthetics of the nails, but may also cause pain, especially when the nails are squeezed or collided. Serious haemorrhagic infections can also lead to a ditch, further exacerbating the discomfort of patients.
(iii) Diagnostic methods
1. Clinical observation
Basic doctors can make a preliminary assessment of fungal infections by looking at changes in the morphology and colour of nails. Typical ash fingernails are often easier to identify, but some unusual cases require further examination.
Funcular examinations
Microscopes can be used to take fingernail shreds under the microscope to see if fungal silks or spores exist. This method is simple and fast, but has limited sensitivity. Facts can also be cultivated, and the fungi that is produced can further determine the type and facilitate the selection of appropriate therapeutic drugs, but it takes time and conditions.
Treatment in primary health care institutions
(i) Partial treatment
1. External drugs
– Amoroffine: this is a common external antifluct drug that can form a protective film on the surface of the nails, and the drugs can be slowly released and work inside the nails. At the time of its use, it is required to be regularly painted, as required by the instructions, usually one or two times a week, for several months. In the case of mild platinum infections, especially in the long end of the fingernails, the amoprovent is more effective.
– Emulsion of cyclopyridone: has a strong permeability and inhibits fungi growth. The patient is allowed to do one or two times a day, evenly covering the sick nails and the skin around them. This drug has had a better effect and relatively small side effects on fingernail infections caused by skin scabies. In providing guidance to patients on the use of external drugs, doctors at the grass-roots level emphasize the importance of maintaining the use of drugs, which take time to function because of the slow growth of nails.
2. Nail cutting and care
Guide patients to correct fingernails to avoid overcuting leading to nail damage and to increase infection. Special nail blades can be used to cut the sick nails as short as possible, but not to the nail bed. At the same time, the skin around the fingernails is kept clean and dry to avoid long-term immersion in water. For some of the thicker and visible nails, they can be softened with warm water before being trimmed.
(ii) Systematic treatment
1. Oral anti-fist drugs
– Ictarconium: This is a broad-spectrum anti-foulbacterial drug, which is widely used in the treatment of pythococcal infections. Primary health-care facilities have access to shock therapy, i.e. one week per month, two times a day, each 200 mg, for three to four months. This method of delivery reduces the side effects of the drug while ensuring its efficacy. However, prior to the use of the Ictarconium, the patient ‘ s medical history, especially if hepatic, is asked, as the drug may have some effect on the liver function, which is periodically examined during the time of use.
– Tebbiphene: There are better therapeutic effects on fingernail infections caused by skin bacterium. In general, continuous oral treatment at 250 mg/day takes 6 – 8 weeks for the treatment of fingernail infections and 12 – 16 weeks for toenails. In the course of treatment, patients are informed of possible adverse effects, such as gastrointestinal disorders, rashes, etc., and in case of unusual and timely withdrawal and re-diagnosis.
IV. Patient education and follow-up
(i) Patient education
1. Knowledge of diseases
Explain to the patient the cause, the route of transmission and the process of treatment of the disease, which is curable but requires patient treatment. The patient is advised to take care of his/her personal hygiene in his/her daily life and to refrain from sharing with others items such as slippers, towels and nails to prevent the spread of the disease.
2. Treatment-based sex education
Emphasis was placed on the importance of adherence to treatment, whether external or oral, in accordance with the course of treatment and in the absence of a self-disposal. Many patients discontinue treatment after a slight reduction in symptoms, which can easily lead to repeated cases.
(ii) Follow-up visits
Establishment of patient follow-up files and regular patient follow-up. The results of the treatment and the adverse effects of the drug are known through telephone follow-up or outpatient visits. If treatment does not work optimally, the treatment programme is adjusted in a timely manner; if there is a negative response, recommendations for treatment are made accordingly.
Conclusions
Primary health-care facilities are required to apply a combination of local and systematic treatments for the treatment of the disease, while strengthening patient education and follow-up. Science-based treatment strategies can improve the curable rate of cactus infections, improve the quality of life of patients and provide effective medical services to a wide range of patients.
